Epidemiological Survey of Metal Allergy and its Relationship with Oral Metal Restorations

在我们的生活环境中，由金属引起的致敏和过敏性病变经常被报道。然而，到目前为止，牙医对金属修复体引起的致敏或皮肤或粘膜损伤的关注很少。我们成立了一个由14个研究机构组成的小组，对18种牙科金属进行斑贴试验，并对斑贴试验阳性受试者进行流行病学调查。在研究之前，测试溶液的应用和皮肤反应的读数都是标准化的。在研究期间召开了三次会议来评估研究，解决任何问题，讨论计划和组织结果。贴片试验是在志愿者和病人身上进行的，总共有1732名受试者。对于那些对贴片试验有积极反应的患者，采用Inoue等人开发的方法对口腔内修复体进行金属分析。然后将分析结果与斑贴试验结果进行比较，探讨两者之间的关系。收集了以下数据并进行了讨论：(1)全体受试者的贴片试验阳性/阴性率，(2)他们在性别、年龄或某种金属方面的差异，(3)地区差异，(4)贴片试验结果阳性的个体与其口内金属修复的关系，(5)病变的类型和位置，(6)患者组的贴片试验阳性率（总体和每种金属），(7)志愿者组和患者组的贴片试验阳性率的差异，(8) M-9、M-11、M-13系列及不同浓度测试溶液中贴片试验阳性率的比较；(9)贴片试验与贴片确认试验结果的比较；（10）贴片试验期间贴片反应的变化；（11）两种不同贴片的贴片皮炎发病率。

Sensitization and allergic lesions resulting from the metals in our living environment have often been reported. However, dentists have paid little attention so far on sensitization or dermal or mucosal lesions caused by metal restorations. We have established a team of 14 research institutions to perform patch tests with 18 kinds of dental metals and to conduct an epidemiological survey on the patch test positive subjects.Prior to the study, application of the testing solutions and reading of the skin reactions were standardized. Three meetings were held during the research period to evaluate the study, solve any problems, discuss the plan and organize the results. Patch tests were done on volunteers and patients with the total of 1, 732 subjects. Metal analysis for the intraoral restorations was done by the method developed by Inoue et al., on those patients who showed positive reactions to the patch tests. The analysis results were then compared to the patch test results to investigate the relation between the two.The following data was collected and discussions were made : (1) patch test positive/negative rates for the total subjects, (2) their differences regarding sex, age, or a kind of metal, (3) regional difference, (4) relation between an individual with patch test positive result and his/her intraoral metal restoration(s), (5) types and locations of the lesions, (6) patch test positive rate (overall and of the each metal) for the patient group, (7) difference in the patch test positive rate between the volunteer group and the patient group, (8) comparison between the patch test positive rates among the M-9, M-11 or M-13 series, and among the different concentrations of the testing solutions, (9) comparison of the results between patch tests and their confirmation tests, (10) changes in the patch test reaction during the testing period, (11) incidence rate of bandage dermatitis according to the two different bandages.